Organization
RED EARTH OSTEOPATHIC MEDICINE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA LEE WILSON DO (PHYSICIAN)
(405) 517-1704
Entity
Organization
Contact information
Practice address
905 N FLOOD AVE, NORMAN, OK 73069-7641
(405) 928-1922
(222) 222-2222
Mailing address
1600 BURLWOOD RD, NORMAN, OK 73026-0745
(405) 517-1704
(111) 111-1111
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
3300
OK
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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